I felt this survey should have asked why antidepressants were prescribed for Fibromyalgia, and also if people had used antidepressants prior to FM/CFS. For example, was the antidepressant prescribed to help with the pain of your condition, for depression, or to achieve sounder sleep, etc. I recently read an article on low cortisol, which also can cause most of Fibromyalgia & chronic fatigue's symptoms, (especially chronic fatigue) that long-term antidepressant use can cause low cortisol. I had been on Paxil for well over 20 years for depression and anxiety disorder prior to developing Fibromyalgia and in the last two years ever worsening chronic fatigue and low thyroid, low cortisol. I'd be very interested in knowing what percentage of patients with these conditions had been on antidepressants long term prior to their diagnosis. I've researched clinical studies a lot and to date have not come across any that looked at brain chemistry changes as a possible cause, and not many looking at hormones. I didn't see Pristiq on that list either and it is being prescribed for these conditions supposedly with a good percentage of favorable results. – xtingley

I have been prescribed probably every drug available in the class. The only one tolerable is Elavil. It does have annoying side effects that new go away with longer term use. One is constant dry mouth & hoarseness of voice. The other is difficultly urinating in the morning if taking an evening dose. The positive side is it does help me sleep longer & fall asleep faster. It also seems to lesson the frequency & severity of migraine headaches. Especially when paired with a beta blocker metoprolol, I take for high BP. A gentlemen made a comment on this article & asked about medication being applied by injection to his specific areas of pain. That is available & called a trigger point injection. My fibro doc is a Physical Medicine & Rehabilitation Specialist. He offers the injections. For those squeamish about needles, a good certified massage therapist, medical message therapist or physical therapist can release the trigger spots temporarily. If you feel you want longer term relief & can tolerate injections it should give most patients at least some relief. This illness is so frustrating. Nothing seems to work for any length of time. We also still have credibility issues despite our growing numbers of people with this puzzling pain syndrome. I believe fibromyalgia is a hyper vigilant central nervous system disorder & that is why is manifests differently in each patient. I think after the body is screaming at us to stop the pain with no success, an autoimmune & adrenal response occurs, making diagnosis & successful treatment even more unlikely. – LauraLee0302

I was diagnosed with fibromyalgia in 2001, and was put on a wide variety of drugs over time, and took as many as ten at a time. Each time, my doctor would as if the drug was helpful, and my response for most was, "I don't know. Maybe it would have been worse without it." However, about a year after Lyrica was approved for the use of fibromyaliga, I tried it. Wow! Now I really knew how to answer the question. The difference was like night and day. Almost immediately, my pain levels decreased dramatically and my sleep was also improved in a big way. Being on Lyrica allowed me to wean off everything except Lyrica, and I've recently decreased even the Lyrica from 300MG daily to 200 MG per day. There is not question to me that Lyrica is doing something to the part of the brain that has been seriously impaired. – pearls

Both gabapentin and pregabalin act on the a2d-1 subunnit of voltage-gated calcium channels. Mainly the pre-synaptic terminals of the dorsal root ganglion neurons and probably the dorsal root horn neurons. These have been implicated in the fibromyalgia pathology. Gabapentin also modulates NMDA receptors, pKc and some inflammatory cytokines or their miRNA. This is why pregabalin and gabapentin can be effective. Those people with spinal compression fracture or stenosis will benefit most. Some people seem not to have spinal involvement and seem to benefit less. Of course this is also very muddy due to unclear diagnostic criteria. – IanH

Q: Karen, or anyone - can you tell me what the status is with Thiamin treatment? Is anyone doing a larger trial? Is the Thiamin still working for you?? I ordered my Thiamin, but have to wait a week - it is on back-order. I am not very well-connected, but I don't understand why I haven't read more about this. – PamJ12

A: The Italian research team is continuing to study the use of thiamin to successfully treat the fatigue that accompanies a number of diseases – most recently inflammatory bowel disease and Hashimoto's thyroiditis. As far as I know, they are the only ones doing this type of research. I suspect the reason you haven't heard more about it is that these are still very small initial studies. I hope eventually they will be able to expand their research to double-blind studies with more participants.

Yes, the thiamin is still working very well for me. I have recently been able to lower my dosage from 1500 mg/day to 1250 mg/day with no decrease in energy. – Karen Lee Richards